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PICC Line



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Dec 14, 2008 01:08 AM

PICC Line

by VAJenny

When a patient has a dual lumen PICC, is it acceptable to have a continuous infusion such as blood or insulin infusing while the other lumen has intermittent antibiotics? same for triple lumens?

and where would i be able to find some evidenced based practice on this.


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11 Comments
No. 1
from iluvivt
Old Dec 14, 2008, 02:51 AM

Default Re: PICC Line
The answer is YES you can. As with any multi-lumen central venous catheter each lumen is separate. So if you have a triple lumen PICC each lumen is separate and you can infuse incompatible drips and medications as long as they are attached to the individual lumens...so you could have blood products in one....Dopamine in the other,,,and a medication line in the other. There are many catheter designs,valved and non-valved catheters and staggered tip designs but any multi-lumen CVC can be used this way.
Optimally, the tip should be in the SVC,unless physiologic or anatomic reasons prevent it,and medications are dumped into this large high volume vessel with excellent hemodilution. What kind of evidence are you looking for that it is OK to do this or what. The catheters are designed by the manufacturer to serve this purpose.
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No. 2
from VAJenny
Old Dec 14, 2008, 09:10 PM

Default Re: PICC Line
I am looking for information that says you can do this, because I work with senior nurses who think that you cannot run (say...blood, tpn, insulin)--continuous infusion at the same time as other medications such s antibiotics..
i guess i can get this information from the company.
i always like to have information to back up what i say, i was pretty sure you could do this.
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No. 3
from RNx2
Old Dec 15, 2008, 10:14 PM

Default Re: PICC Line
Originally Posted by VAJenny View Post
I am looking for information that says you can do this, because I work with senior nurses who think that you cannot run (say...blood, tpn, insulin)--continuous infusion at the same time as other medications such s antibiotics..
i guess i can get this information from the company.
i always like to have information to back up what i say, i was pretty sure you could do this.
Home Healthcare Nursing had an article in the Sept 07 issue that may help your friends understand about peripheral IVs and central lines, like PICCs. Here is a link to the article at Nursing Center. http://www.nursingcenter.com/prodev/...asp?tid=745323
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No. 4
from AirforceRN
Old Dec 15, 2008, 11:08 PM

Default Re: PICC Line
Although this is doable...you always have to be careful while infusing two things at the same time. If the patient has a reaction, obviously both infusions will be stopped, but which one caused the reaction? I wouldn't run anything with a first dose of antibiotics just to be on the safe side.
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No. 5
Old Dec 15, 2008, 11:23 PM

Default Re: PICC Line
Wow, this thread is deja vu to me. Somebody asked a nearly identical question a week or two ago:
http://allnurses.com/forums/f86/can-...th-349033.html

Granted, that one's about a CVC, but I think you'll find the discussion helpful.
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No. 6
from iluvivt
Old Dec 15, 2008, 11:30 PM

Default Re: PICC Line
Va jenny, the nurses you are trying to educate simply do not understand catheter design. If you go to any manufactures web site you will find pictures of their available catheters. They will have a cross section view that clearly explains and shows you how each lumen is separate. Do you know what type of CVC or PICC brand you are using and I can further explain anything special about that particular catheter. Please feel free to bring them a copy of this discussion. I can also give you a reference if you like and would even photocopy any section from my multiple infusion therapy books, I just bought a ton of new books to study for my recertification of my CRNI. I would be more than happy to do this. Just PM me and let me know where I can send it. Some of these books can be quite costly....the INS one is about 100 bucks or so.
Although it is a good idea to infuse first doses without other medications that have a propensity to cause a hypersensitivity reaction, this is not always feasible. There are many drips that you can not just stop. I certainly would not infuse two first doses of such medications if I had the option. Way to go for finding out the way to use these catheters. Let me know if I can help you with anything else
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No. 7
from VAJenny
Old Dec 16, 2008, 01:25 AM

Default Re: PICC Line
WoW! Thanks for all the feedback on this topic..I just joined Allnurses.com a few days ago and love it already...
the catheter brand we use is BD..
I just do not understand why they think you cannot run a continuous infusing and intermittent meds throught a dual lumen picc.that is what it is designed for....what about incompatible meds?
i will check out these websites!!
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No. 8
from VAJenny
Old Dec 16, 2008, 01:42 AM

To iluvit..if you have any info related to this subject we are talking about that would be great...how do i PM you?
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No. 9
Old Dec 16, 2008, 05:44 AM

Default Re: PICC Line
Originally Posted by VAJenny View Post
what about incompatible meds?
Just tell 'em that ALL medications are compatible once mixed and diluted into blood plasma volume.
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